The toes are made up of small bones (called phalanges), which can easily break following trauma. Most toe fractures are referred to as "stress" or "capillary"; in this case the damage is superficial and is not so severe as to misalign the bones or break the surface of the skin. In less frequent cases, a toe can be crushed in such a way as to completely shatter the bones (multiple fracture) or the break can even misalign the bones to the point that the stump protrudes from the skin (in this case we speak of an open fracture). It is essential to understand the severity of the injury in order to determine the specific treatment to follow.
Steps
Part 1 of 4: Getting a Diagnosis
Step 1. Schedule a visit to the doctor
If you experience sudden pain in your toe after a foot injury that does not go away within a few days, you should go to your family doctor for an examination. He will check your toe and foot, ask you some questions about the dynamics of the injury, and may also order an x-ray to determine the severity of the injury and check for other types of fractures. However, your primary care physician is not a musculoskeletal specialist, so they may recommend that you see an orthopedist.
- The most common symptoms of a toe fracture are intense pain, swelling, stiffness, and sometimes bruising caused by internal bleeding. It is very difficult to walk and virtually impossible to run or jump without excruciating pain.
- Other medical specialists you may turn to to have a broken toe diagnosed include the osteopath, the podiatrist, the chiropractor and the physiotherapist; however, only the podiatrist and orthopedist can reach a formal diagnosis and draw up a therapeutic plan, because they are the only figures to whom the Ministry of Health entrusts these skills.
Step 2. Get examined by a specialist
Small capillary (stress) fractures, the detachment of minute bone fragments or bruises are not considered serious medical problems, but if your fingers have been severely crushed or you have displaced fractures, surgery is often required, especially if the toe in question is the big toe. A specialist doctor, such as an orthopedist (bone and ligament specialist) or a physiatrist (bone or muscle specialist) can study your problem more effectively, understand its severity and recommend the most appropriate treatments. A broken toe is sometimes associated with some other underlying disease that can affect and weaken the bones, such as bone cancer or infection, osteoporosis, or some complication resulting from diabetes. therefore a specialist is certainly able to take these aspects into consideration during the visit.
- Your doctor may use several tests to diagnose the problem with your finger, such as an x-ray, bone scan, MRI, CT scan, and ultrasound.
- Often a toe can break due to some heavy object that has fallen on it or from a strong impact against some hard and immobile object.
Step 3. Find out about the type of fracture and the best possible treatments
Make sure your doctor clearly explains your diagnosis (including the type of fracture you suffered) and tells you about the various options available to you for treating the injury, as a simple stress fracture can often be cured easily at home. Otherwise, if the finger is mangled, bent or deformed, it means that the fracture is really serious and requires more specialized medical attention.
- The little toe and big toe are the toes that break most often.
- A joint dislocation can change the shape of the finger by simulating the appearance of a fracture, but a physical exam and x-ray will be able to distinguish the two types of problems.
Part 2 of 4: Treating the Stress Fracture
Step 1. Follow the "R. I. C. E
". Most treatments for minor injuries to the musculoskeletal system (such as stress fractures) follow a protocol that is commonly abbreviated as "R. I. C. E.", from the English acronym corresponding to Rest (rest), Ice (ice), Compression (compression) ed Elevation (elevation). The first point - rest - indicates that you must stop any type of activity that can aggravate the injury. The next - ice - involves following as soon as possible a cold therapy (an ice pack wrapped in a thin cloth or a cold gel pack) on the broken finger, in order to stop a possible internal bleeding in the bud and reduce the inflammation; the treatment is even more effective if the leg is raised, resting it on a chair or a pile of pillows (which, among other things, fights inflammation). Ice should be applied for 10-15 minutes every hour, then you can reduce the frequency as the pain and swelling subside within a few days. The third point - compression - consists in compressing the ice on the injured area using a bandage or elastic support; by doing so, you keep inflammation under control.
- Do not overtighten the bandage and do not hold it for more than 15 minutes each time, to avoid completely blocking the blood circulation with even more serious consequences for the foot.
- Most simple fractures heal well, usually within 4-6 weeks, during which time you should reduce your sporting activities.
Step 2. Take over-the-counter medications
Your family doctor may recommend anti-inflammatories, such as ibuprofen, naproxen, or aspirin, or regular pain relievers (pain relievers) such as acetaminophen, to relieve the inflammation and pain caused by the injury to your finger.
These drugs are quite aggressive to the stomach, liver and kidneys, so you shouldn't take them for more than 2 weeks at a time
Step 3. Band your fingers for support
Block the broken finger with the adjacent healthy one using medical tape; in doing so you support it and facilitate its correct realignment, in case the injured finger is a little deformed. Thoroughly clean your toes and foot with alcohol wipes and use sturdy medical tape, preferably water resistant, so it doesn't come off when you shower. Change the bandage every 2 to 3 days over several weeks.
- Consider putting gauze or soft cloth between your fingers before wrapping them with medical tape if you want to prevent possible skin irritation.
- If you want to make a simple homemade stick for extra support, place sticks like popsicle sticks on both sides of your fingers before wrapping them.
- If you have difficulty binding your own toes, ask your family doctor or specialist (chiropractor, podiatrist, or physiotherapist) to help you.
Step 4. Wear comfortable shoes for 4-6 weeks
In the aftermath of your injury, wear comfortable shoes that offer plenty of toe space to keep the swollen finger and the bandage from being under pressure. Choose shoes that have a stiff sole, that provide good support, that are sturdy and don't think about fashion for the moment; Also, avoid wearing high heels for at least a couple of months, as they push the weight forward and could put extra pressure on your toes.
If you have severe inflammation, wear footwear that supports your foot well and is open at the toe, but remember that this way your toe doesn't have much protection
Part 3 of 4: Treating Open Fractures
Step 1. Undergo reduction surgery
If the broken bone fragments do not line up with each other, the orthopedic surgeon might manipulate them to return them to their normal position (this process is called reduction). In some cases, this type of surgery does not require invasive surgery, depending on the number and location of the bone fragments. Your doctor will inject an anesthetic into your finger to relieve the pain. If the skin is broken due to the trauma, stitches will also be needed to close the wound and you will be given topical antiseptics.
- In the case of an open fracture, timeliness is essential, because there is a risk of severe blood loss, infection or necrosis (the tissue in the area dies due to a lack of oxygen).
- Your doctor will prescribe stronger pain relievers, such as narcotics, until you are given anesthesia in the operating room.
- Sometimes, in the case of severe fractures, pins or screws may be placed to hold the bones in place during the healing period.
- The reduction is not only implemented in the case of open fractures, but also if the injury has caused significant displacement.
Step 2. Wear a brace
At the end of the reduction, a brace is applied to the broken finger to provide support and protection during the recovery period. Alternatively, you can buy an orthopedic boot brace. In both cases, however, you may need crutches for some time (about two weeks). During this time it is highly recommended to walk as little as possible and rest with the affected leg raised.
- While the brace provides support and acts as a bit of a shock absorber, it doesn't offer much protection, so be very careful not to tap your toe on hard surfaces when walking.
- During your recovery period, be sure to eat a diet rich in minerals, especially calcium, magnesium and boron, without neglecting vitamin D to strengthen the injured bone.
Step 3. Put the plaster
If there are more than one broken toes or other bones (such as the metatarsal) are fractured, the doctor may decide to block the whole foot with the classic plaster or fiberglass. Sometimes plaster is applied to below the knee, taking care to insert a support plate under the foot that allows you to walk. This solution is put in place for the bones that do not join well. Most fractures resolve successfully once the bones are repositioned correctly and are protected from the risk of further trauma or from too much pressure.
- After surgery, severely injured fingers typically take 6-8 weeks to heal (especially if a cast was needed), but recovery time depends on the exact location of the fracture and the severity. If the foot remains stuck in the cast for a long time, rehabilitation therapy as described below will be required at the end.
- After a week or two, your doctor may take another series of x-rays to make sure the bone is healing properly.
Part 4 of 4: Managing Complications
Step 1. Check for infections
If the skin near the fractured finger is broken, you are more likely to develop an infection within the bone or surrounding tissue. The infection is manifested by swelling, redness, warm and painful skin to the touch. Sometimes you may notice the presence of even foul-smelling pus (which means that your white blood cells are fighting against infection). If you have suffered an open fracture, your doctor may recommend a 2-week precautionary course of oral antibiotics to prevent bacteria from developing and spreading.
- Your doctor will carefully examine the area and prescribe antibiotics if there is an infection.
- Your doctor may also recommend a tetanus shot if you've sustained a serious injury, especially if it resulted in a cut or tear in your skin.
Step 2. Put on orthotics
These are completely customized inserts that are placed in the shoes to support the arch of the foot and improve the biomechanics when walking or running. If you have broken a toe, especially if it is a big toe, your gait and biomechanics may have undergone a negative change, leading you to limp and avoid contact between the toe and the ground with each step. The insoles also reduce the risk of complications in the ankles, knees or hips.
When you suffer a severe fracture, there is always a risk of developing arthritis in nearby joints, but orthotics reduce this danger
Step 3. Get examined by a physiotherapist
Once the pain and inflammation have subsided and the broken bone has healed, you may notice that the range of motion and strength of the foot has reduced. For this reason, ask your doctor to refer you to the office of a physiotherapist or sports doctor who offers you personalized exercises, such as stretches, and other therapies to regain motility, strength, balance and coordination..
There are also other therapists who can help you with foot rehabilitation, such as the podiatrist, osteopath, and chiropractor
Advice
- If you are diabetic or suffer from peripheral neuropathy (loss of sensation in the toes) do not bandage the broken toe with the one next to it, as you will not be able to feel excessive tension on the medical tape or blisters may form.
- An alternative to anti-inflammatories and analgesics is represented by acupuncture which can give you relief from pain and inflammation localized in the broken toe.
- There is no need for absolute rest to heal a broken toe, just replace those activities that stress the foot with others that do not, such as swimming or weight lifting, which only involve the upper body.
- After about 10 days, replace the cold therapy with hot-moist compresses (you can heat a cloth bag filled with rice or beans in the microwave) to relieve pain and promote blood circulation.
